National context

The background to national policy is one of an ageing population with people living longer. There are more complex, expensive treatments, drugs and improved medical technology. A growing number of people have ‘lifestyle’ diseases and the public has increased expectations from NHS services. The government’s drive to make public services fit for the 21^st century is focussed on introducing a patient-led service.

This will provide:

• more choice and a much stronger voice for patients, in consultation with their clinicians, to choose the highest quality of care appropriate to their needs;
• more support for people with long-term conditions, including support for self-care to help people manage their condition;
• practice based commissioning, through which Primary Care Trusts (PCTs) will work with local practices to get the best value within available resources. This will draw on knowledge of local communities and include extensive patient and public involvement;
• more freedom for providers to innovate and improve services in response to the needs and decisions of patients, GPs and commissioners;
• further expansion of NHS Foundation Trusts;
• more opportunities for voluntary sector, social enterprise and private sector providers where they can help deliver better services with better value for money; and
• an NHS that works in partnership with local authorities and other local services to deliver improvements and to promote equality, inclusion and respect.